Background: The first case of Coronavirus Disease (COVID-19) was reported in Iran on February 19, 2020. This study aimed to assess the characteristics and reproduction number (R) of COVID-19 in Markazi province in Iran.
Methods: This is a cross-sectional study. Confirmed cases (N=2430) in the regions covered by Arak University of Medical Sciences from Feb 20 to Aug 26, 2020 were enrolled in the study. The included variables were clinical and demographic characteristics of COVID-19 patients. The case fatality rate (CFR), incidence rates, and R were estimated based on the daily reported data. For estimating R, generation time was assumed on multi scenarios. R was estimated by R0-package. Moreover, Chi square test was applied. All the analyses were performed in STATA, Excel, ArcMap and R. A p-value less than 0.05 was considered as statistically significant.
Results: The mean age of the participants was 51.78±20.58 years, and 206(8.50%) cases were among healthcare workers. Among the patients, 499(20.50%) had a history of cardiovascular diseases and 337(13.90%) diabetes type 2. The most prevalent symptoms were cough 1347(55.40%), fever 1233(50.70%), and dyspnea 960(39.50%). The highest incidence rate of COVID-19 in the study area (Delijan) was 575.35 per 100,000 persons. CFR was 205(8.40%). At the end of the study period, R was calculated as 1.04 (CI 95%: 1.00, 1.08) in all districts of Arak University of Medical Sciences. The highest R (1.08, 95% CI: 1.06, 1.10) was observed in Farahan.
Conclusion: As R is slightly high, the risk of epidemic has reduced gradually. However, observing social distance and related guidelines are still recommended. |
- World Health Organization. Coronavirus disease 2019 (COVID-19): Situation Report–31. Geneva: World Health Organization; 2020.
- Raoofi A, Takian A, Sari A, et al. COVID-19 pandemic and comparative health policy learning in Iran. Archives of Iranian Medicine. 2020;23:220-34.
- Goudarzi R, Tasavon Gholamhoseini M, Amini S, et al. Estimating the cost of vaccination in southeastern Iran. Human Vaccines & Immunotherapeutics. 2020. DOI: 10.1080/21645515.2020.1725357 [online]
- Verbeek JH, Rajamaki B, Ijaz S, et al. Personal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff. Cochrane Database of Systematic Reviews. 2020;4(4).
- Al-zoubi NA, Obeidat BR, Al-Ghazo MA, et al. Prevalence of positive COVID-19 among asymptomatic health care workers who care patients infected with the novel coronavirus: A retrospective study. Annals of Medicine and Surgery. 2020;57:14-6.
- Bui LV, Nguyen TT, Nguyen H. Early Estimation of Reproduction Number of Covid-19 in Vietnam. Medrxiv. 2020. DOI: 10.1101/2020.03.28.20046136 [preprint]
- Aghaali M, Kolifarhood G, Nikbakht R, et al. Estimation of the Serial Interval and Basic Reproduction Number of COVID‐19 in Qom, Iran, and Three Other Countries: A Data‐Driven Analysis in the Early Phase of the Outbreak. Transboundary and Emerging Diseases. 2020. DOI: 10.1111/tbed.13656 [online]
- Najafi F, Izadi N, Hashemi-Nazari S-S, et al. Serial interval and time-varying reproduction number estimation for COVID-19 in western Iran. New Microbes and New Infections. 2020;36:100715.
- Statistical Center of Iran. Selected Findings of the 2016 National Population and Housing Census. Tehran: Statistical Center of Iran; 2016. [Cited 10 April 2020]. Available from: https://www.amar.org.ir/Portals/1/census/2016/Census_2016_Selected_Findings.pdf
- Moradzadeh R. The challenges and considerations of community-based preparedness at the onset of COVID-19 outbreak in Iran, 2020. Epidemiology and Infection. 2020;148:e82.
- World Health Organization. Diagnostic testing for SARS-CoV-2: interim guidance, 11 September 2020. Geneva: World Health Organization; 2020.
- Kenah E, Lipsitch M, Robins JM. Generation interval contraction and epidemic data analysis. Mathematical Biosciences. 2008;213:71-9.
- Hwang J, Park H, Kim S, et al. Basic and effective reproduction numbers of COVID-19 cases in South Korea excluding Sincheonji cases. MedRxiv. 2020. DOI: 10.1101/2020.03.19.20039347 [preprint]
- Obadia T, Haneef R, Boëlle P-Y. The R0 package: a toolbox to estimate reproduction numbers for epidemic outbreaks. BMC Medical Informatics and Decision Making. 2012;12:147.
- Nikpouraghdam M, Farahani AJ, Alishiri G, et al. Epidemiological characteristics of coronavirus disease 2019 (COVID-19) patients in IRAN: A single center study. Journal of Clinical Virology. 2020;127:104378.
- Ashraf MA, Shokouhi N, Shirali E, et al. COVID-19 in Iran, a comprehensive investigation from exposure to treatment outcomes. Medrxiv. 2020. DOI: 10.1101/2020.04.20.20072421 [preprint]
- Onder G, Rezza G, Brusaferro S. Case-Fatality Rate and Characteristics of Patients Dying in Relation to COVID-19 in Italy. JAMA. 2020. DOI: 10.1001/jama.2020.4683 [online]
- Shahriarirad R, Khodamoradi Z, Erfani A, et al. Epidemiological and clinical features of 2019 novel coronavirus diseases (COVID-19) in the South of Iran. BMC Infectious Diseases. 2020;20:427.
- Schurz H, Salie M, Tromp G, et al. The X chromosome and sex-specific effects in infectious disease susceptibility. Human Genomics. 2019;13:2.
- Robinson DP, Hall OJ, Nilles TL, et al. 17β-estradiol protects females against influenza by recruiting neutrophils and increasing virus-specific CD8 T cell responses in the lungs. Journal of Virology. 2014;88:4711-20.
- Lei S, Jiang F, Su W, et al. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. EClinicalMedicine. 2020;21:100331.
- Tan SC. Clinical and epidemiological characteristics of Coronavirus Disease 2019 (COVID-19) patients. Medrxiv. 2020. DOI: 10.1101/2020.04.02.20050989 [preprint]
- Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020. DOI: 10.1001/jama.2020.2648 [online]
- Remuzzi A, Remuzzi G. COVID-19 and Italy: what next? The Lancet. 2020;395:1225-8.
- International Council of Nurses. High proportion of healthcare workers with COVID-19 in Italy is a stark warning to the world: protecting nurses and their colleagues must be the number one priority. Geneva: International Council of Nurses; 2020. [Cited 14 April 2020]. Available from: https://www.icn.ch/news/high-proportion-healthcare-workers-covid-19-italy-stark-warning-world-protecting-nurses-and
- Kluytmans M, Buiting A, Pas S, et al. SARS-CoV-2 infection in 86 healthcare workers in two Dutch hospitals in March 2020. Medrxiv. 2020. DOI: 10.1101/2020.03.23.20041913 [preprint]
- Chowell G, Abdirizak F, Lee S, et al. Transmission characteristics of MERS and SARS in the healthcare setting: a comparative study. BMC Medicine. 2015;13:210.
- Twu S-J, Chen T-J, Chen C-J, et al. Control measures for severe acute respiratory syndrome (SARS) in Taiwan. Emerging Infectious Diseases. 2003;9:718-20.
- Vali L, Tabatabaee SS, Kalhor R, et al. Analysis of productivity improvement act for clinical staff working in the health system: A qualitative study. Global Journal of Health Science. 2016;8:106-16.
- Fisher D, Heymann D. Q&A: The novel coronavirus outbreak causing COVID-19. BMC Medicine. 2020;18:57.
- Li Q, Guan X, Wu P, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus–infected pneumonia. The New England Journal of Medicine. 2020;382:1199-207.
- Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020;395:497-506.
- Zhang J, Litvinova M, Wang W, et al. Evolving epidemiology of novel coronavirus diseases 2019 and possible interruption of local transmission outside Hubei Province in China: a descriptive and modeling study. Medrxiv. 2020. DOI: 10.1016/S1473-3099(20)30230-9 [preprint]
- Koolivand A, Amini S. The importance of PHC-based measures in controlling COVID-19 outbreak: Implications for global health system. Ethics Medicine and Public Health. 2020;14:100549. DOI:10.1016/j.jemep.2020.100549
- Bai Y, Yao L, Wei T, et al. Presumed asymptomatic carrier transmission of COVID-19. JAMA. 2020;323:1406-7.
- Chen T-M, Rui J, Wang Q-P, et al. A mathematical model for simulating the phase-based transmissibility of a novel coronavirus. Infectious Diseases of Poverty. 2020;9:24.
- Read JM, Bridgen JR, Cummings DA, et al. Novel coronavirus 2019-nCoV: early estimation of epidemiological parameters and epidemic predictions. MedRxiv. 2020. DOI: 10.1101/2020.01.23.20018549 [preprint]
- Sahafizadeh E, Sartoli S. Estimating the reproduction number of COVID-19 in Iran using epidemic modeling. Medrxiv. 2020. DOI: 10.1101/2020.03.20.20038422 [preprint]
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